Prenatal cocaine exposure (PCE) is associated with deficits in behavioral regulation and attention. However, the behavioral and brain mechanisms underlying these outcomes have not been clearly defined. Using fMRI, this study will characterize the link between PCE, neurocognitive performance, and the underlying neural substrates associated with behavioral outcomes of attention. We will examine how PCE affects different aspects of attention using the theoretical model proposed by Posner and Petersen (1990). The model posits three dissociable components of attention: alerting, orienting, and executive attention. Subjects for the proposed study will be young adults selected from the ongoing Maternal Health Practices and Child Development Project (MHPCD) cohort, a longitudinal study of the effects of PCE on growth, behavior, and cognitive function. In the parent study, we have found effects of PCE on cognitive function in areas such as behavioral regulation, attention, memory, and mental flexibility. We will compare 3 groups: 1) prenatal exposure to cocaine, alcohol, marijuana, and tobacco (CAMT), 2) prenatal exposure to alcohol, marijuana, and tobacco (AMT), and 3) no prenatal exposure to drugs (Controls). These groups represent the reality of prenatal substance exposure: Most offspring with PCE are exposed to multiple drugs. Subjects will be frequency matched on other prenatal exposures, sex, race, handedness, and 15-year IQ. Subjects will undergo a functional MRI scan while performing the Attention Network Task, a validated neuroimaging measure of attention. Comparison of the CAMT and Control groups will provide information on the overall effects of polydrug exposure on the attention and brain activation measures. A comparison of CAMT to AMT will allow us to determine how PCE interacts with other prenatal substance exposures to affect attention. In addition, a major strength of the proposal is that we have detailed information about prenatal and postnatal drug exposures, as well as demographic, psychological, social, and environmental assessments on the offspring and mothers. This work is important because it will provide critical information for women making decisions about substance use behavior during pregnancy and for use in conjunction with other research to design appropriate intervention or rehabilitation programs for cocaine-exposed individuals. PUBLIC HEALTH RELEVANCE: Prenatal cocaine exposure (PCE) is a major public health concern, causing negative health outcomes for both mothers and offspring. The proposed research will identify the link between PCE and neurocognitive performance and the underlying neural substrates associated with specific behavioral measures of attention. This research will provide crucial information for the identification of and intervention with exposed offspring.